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Name: Ketogenic Diets

Description:

This casebook is published and has been read 290 times.

The author of this casebook has identified the following medical topics as being highly relevant to this casebook.

  • Diabetes Mellitus, Non-Insulin-Dependent -- subclass of diabetes mellitus that is not insulin responsive or dependent; characterized initially by insulin resistance and hyperinsulinemia and eventually by glucose intolerance, hyperglycemia, and overt diabetes; type II diabetes mellitus is no longer considered a disease exclusively found in adults; patients seldom develop ketosis but often exhibit obesity.
  • Epilepsy -- A disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns (e.g., nocturnal epilepsy). (From Adams et al., Principles of Neurology, 6th ed, p313)
Notes
Curr Opin Clin Nutr Metab Care. 2008 Mar;11(2):113-20.

The ketogenic diet and epilepsy.

Source

Barrow Neurological Institute, St. Joseph's Hospital & Medical Center, Phoenix, Arizona 85013, USA. doyoung.kim@chw.edu

Abstract

PURPOSE OF REVIEW:

The ketogenic diet has long been used to treat medically refractory epilepsy. The mechanisms underlying its clinical effects, however, have remained a mystery. The evidence to date suggests that a fundamental shift from glycolysis to intermediary metabolism induced by the ketogenic diet is necessary and sufficient for clinical efficacy. This notion is supported by a growing number of studies indicating that glucose restriction, ketone bodies and polyunsaturated fatty acids may all play mechanistic roles, possibly by enhancing mitochondrial respiration and ATP production, and decreasing reactive oxygen species production.

RECENT FINDINGS:

Recent reports indicate that ketone bodies can reduce oxidative stress and that fatty acid-induced mitochondrial uncoupling may also yield similar protective effects. Ketone bodies may attenuate spontaneous firing of ATP-sensitive potassium channels in central neurons, and pharmacological inhibition of glycolysis has been shown to retard epileptogenesis in a rat kindling model.

SUMMARY:

While the mechanisms underlying the broad clinical efficacy of the ketogenic diet remain unclear, there is growing evidence that the ketogenic diet alters the fundamental biochemistry of neurons in a manner that not only inhibits neuronal hyperexcitability but also induces a protective effect. Thus, the ketogenic diet may ultimately be useful in the treatment of a variety of neurological disorders.

PMID: 18301085
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Appetite. 2008 Mar-May;50(2-3):550-4. Epub 2007 Nov 13.

Weight and weddings: women's weight ideals and weight management behaviors for their wedding day.

Source

Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA. neighboL@uwm.edu

Abstract

We conducted a descriptive cross-sectional survey to examine wedding-specific body weight ideals and weight management behaviors among women preparing for their wedding (n=272). The average bride-to-be was overweight according to clinical body mass index standards and idealized a significantly lower wedding weight. Most were attempting to lose weight and reported a small but significant weight loss using a combination of weight loss behaviors. Many women used one or more extreme weight loss behaviors. Additionally, some women reported purchasing a smaller-sized wedding dress, potentially to constrain behavior. Prior to weddings, interventions promoting a healthy, sustainable lifestyle may be useful to discourage extreme weight loss behaviors and emphasize healthy long-term weight management.

PMID:18160128
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Obes Rev. 2009 Jan;10(1):36-50. Epub 2008 Aug 11.

Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities.

Source

Centre for Obesity Research and Epidemiology (CORE), Faculty of Heath and Social Care, Robert Gordon University, Aberdeen, UK.

Abstract

There are few studies comparing the effects of low-carbohydrate/high-protein diets with low-fat/high-carbohydrate diets for obesity and cardiovascular disease risk. This systematic review focuses on randomized controlled trials of low-carbohydrate diets compared with low-fat/low-calorie diets. Studies conducted in adult populations with mean or median body mass index of > or =28 kg m(-2) were included. Thirteen electronic databases were searched and randomized controlled trials from January 2000 to March 2007 were evaluated. Trials were included if they lasted at least 6 months and assessed the weight-loss effects of low-carbohydrate diets against low-fat/low-calorie diets. For each study, data were abstracted and checked by two researchers prior to electronic data entry. The computer program Review Manager 4.2.2 was used for the data analysis. Thirteen articles met the inclusion criteria. There were significant differences between the groups for weight, high-density lipoprotein cholesterol, triacylglycerols and systolic blood pressure, favouring the low-carbohydrate diet. There was a higher attrition rate in the low-fat compared with the low-carbohydrate groups suggesting a patient preference for a low-carbohydrate/high-protein approach as opposed to the Public Health preference of a low-fat/high-carbohydrate diet. Evidence from this systematic review demonstrates that low-carbohydrate/high-protein diets are more effective at 6 months and are as effective, if not more, as low-fat diets in reducing weight and cardiovascular disease risk up to 1 year. More evidence and longer-term studies are needed to assess the long-term cardiovascular benefits from the weight loss achieved using these diets.

PMID:18700873
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Mol Cell Biochem. 2007 Aug;302(1-2):249-56. Epub 2007 Apr 20.

Beneficial effects of ketogenic diet in obese diabetic subjects.

Source

Department of Surgery, Faculty of Medicine, Kuwait University, PO Box 24923, 13110 Safat, Kuwait. info@drdashti.com

Abstract

OBJECTIVE:

Obesity is closely linked to the incidence of type II diabetes. It is found that effective management of body weight and changes to nutritional habits especially with regard to the carbohydrate content and glycemic index of the diet have beneficial effects in obese subjects with glucose intolerance. Previously we have shown that ketogenic diet is quite effective in reducing body weight. Furthermore, it favorably alters the cardiac risk factors even in hyperlipidemic obese subjects. In this study the effect of ketogenic diet in obese subjects with high blood glucose level is compared to those with normal blood glucose level for a period of 56 weeks.

MATERIALS AND METHODS:

A total of 64 healthy obese subjects with body mass index (BMI) greater than 30, having high blood glucose level and those subjects with normal blood glucose level were selected in this study. The body weight, body mass index, blood glucose level, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, urea and creatinine were determined before and at 8, 16, 24, 48, and 56 weeks after the administration of the ketogenic diet.

RESULTS:

The body weight, body mass index, the level of blood glucose, total cholesterol, LDL-cholesterol, triglycerides, and urea showed a significant decrease from week 1 to week 56 (P < 0.0001), whereas the level of HDL-cholesterol increased significantly (P < 0.0001). Interestingly these changes were more significant in subjects with high blood glucose level as compared to those with normal blood glucose level. The changes in the level of creatinine were not statistically significant.

CONCLUSION:

This study shows the beneficial effects of ketogenic diet in obese diabetic subjects following its long-term administration. Furthermore, it demonstrates that in addition to its therapeutic value, low carbohydrate diet is safe to use for a longer period of time in obese diabetic subjects.

PMID:17447017

 





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 A low-carbohydrate, ketogenic diet to treat type 2 diabetes Treatment of Type II Diabetes with Ketogenic Diet
 

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